Reena.
Coma.
Dr. Callendar ignored me while he ragged on Omar, one of the other residents. Then he turned to me. On autopilot, I reviewed my eighty-two year-old lady with hypertension, osteoporosis, and a remote MI, here for a blood pressure check.
Dr. Callendar managed to slice his way through my haze. "You shouldn't be here."
I bit my lip. Dr. Callendar had hated me from the get-go, kind of like Reena, come to think of it. Still, I was surprised he was so abrupt with me, considering I'd been strangled and all, until he said, "You should take a month off. More if you need it."
Oh. He was actually trying to be nice to me in a screwed-up, Twilight kind of way. Right. Me. Post-traumatic stress. By this point, I had so much new stress, the almost-being-strangled stress felt like old news. But it was nice to know Dr. Callendar preferred me breathing and even rested rather than six feet under. I focused on his greying black crew cut and told it, "If I took a month off, I'd have to add an extra month to my training. I'm not willing to do that."
He shuffled through the files in front of him and coughed. "You might...there have been exceptions."
Curiouser and curiouser. I almost smiled at him. "I want to get back to work, too. I was going crazy sitting at home."
"You might go crazy here too, doing psych," Stan said.
Dr. Callendar shrugged. "It's your decision. But don't expect any special treatment."
Ah. The old Dr. C I knew and loathed. I met his eyes. "I never do."
"Good." A smile played around his thin lips as he handed me a manila file. "Meet Mrs. Valdez, your new thirty-nine year-old primip with gestational diabetes, in her thirty-sixth week."
In other words, a first-time mother with a strong chance of having a giant baby, and taking two days to deliver it vaginally.
Dr. Callendar continued, at higher volume for Tori and Stan, who'd joined us with their own cases to review: "Sometimes the CLSC gets patients who are late in their pregnancy—some of them are refugees from other countries. Of course, the CLSC doctors don't deliver, but we do. I thought Hope would enjoy some obstetric experience, especially since she's on psychiatry, which only has home call." He nodded at the chart. "Why don't you take a minute to familiarize yourself with the patient, and then, if you have any questions, bring them up after the others have reviewed their patients."
Glumly, I opened the chart.
Dr. Callendar tapped a sheet of paper with his pen. "Oh, and Hope. Gestational diabetes is a fascinating subject. Why don't you do a presentation on that for us, at our next obstetrical meeting."
I tried not to show any emotion. As far as I could see, he'd pretended to care about my near-death encounter just to provoke me more, like offering a massage before delivering a right cross. He'd feed off any sign of despair.
It was almost enough to make me look forward to psych call.
Reena.
Coma.
***
I rushed into the emerg at 4:55, hoping Reena hadn't made it to the ICU yet. On the psych desk, I found a copy of the psych consult: 29 y.o. F, known to you, OD, SVP assess for suicidality when medically clear.
I covered my eyes.
I heard low-heeled shoes tap toward me and a heavy body lower into the chair beside me. "Don't blame yourself," said Brigitte, the evening psych nurse.
I looked into her plump, rosy face and asked, "How can I not?"
"We all blame ourselves when a patient comes in after we've sent them home. But you didn't make her take those pills."
True. But, at the most fundamental level, she came to the emergency room asking for help. And I obviously didn't give it to her.
I tried to concentrate on the medical part. "Do we know what she took?"
Brigitte shook her head. "We're waiting for the tox screen. She's not on anything, and the paramedics didn't find any bottles at the scene."
I glanced at the resus room. "Is her friend Jodi with her?"
Brigitte shook her head. "No one but family. Her sister was the one who called 911."
Was Jodi actually her sister? They didn't look alike, not that it meant anything, but the vibe was not what I'd call sisterly. "Is her sister with her now?"
"Yes. I'm just getting her papers together. They're about to move her up to the unit."
Once Reena left the emerg, I wasn't officially responsible for the psych consult anymore. Not that they'd probably want me to do it.
I walked over to resus. For the first time in my fledgling medical career, I cringed slightly as I drew back the curtain, afraid of what I might find.
Reena was intubated. I'd kind of expected that, since she was going to ICU, but it still shocked me to see the tube down her throat and taped to her face. Her eyes were slitted closed, and her chest moved up and down, hissing in time with the respirator. Two IV's, and an O2 monitor on her finger. Her face was pale but sweaty.
I would not have recognized her, behind all the equipment, except for her curly hair spilling over the pillow.
"Are you another nurse?" said the girl beside the bed, pocketing her cell phone. It wasn't Jodi. She had brown skin and long, shiny black hair. She was pretty except for slightly crooked teeth. She looked native Canadian to me. Nothing like Reena, except they both had the same solid build.
"No. I'm Dr. Hope Sze, a resident in psychiatry."
Her eyebrows jerked upward. "Ha! I see." She paused. "Get it? It's funny because of your name."
I'd already heard all the jokes about my last name, from sze-sick to Great Big Sze. I faked a smile. I don't have a sister, but I doubt I'd joke around if mine were in a coma. "Yes. I'm sorry about your sister."
A peculiar expression crossed her face. "Is she going to be all right?" Her voice rose and trembled at the end. She was younger than she looked. Maybe this was just her way of freaking out.
"I hope so. We're doing our best."
Her shoulders sagged as she surveyed the equipment. "I know."
We watched Reena's chest rise and fall with the respirator for a moment before a heavy-set woman in black burst in. "Oh, Wendy, Wendy, Wendy—" She wrapped her arms around the sister. "I can't stand it. It's too awful. I never got to talk to her. The last thing I told her was that she should get a better job, she'll never know that I love her—"
"It's okay, Mom," said Wendy, muffled, into her shoulder. "I know."
"I couldn't stand to lose both my girls, you know that."
"I know."
The respiratory therapist and an orderly entered the room, swiftly followed by an emerg nurse who unplugged Reena's equipment and re-plugged her into a portable monitor and ventilator. "Her bed's ready upstairs," explained the nurse, Véronique, as she scooped up the chart.
Reena's mother pulled a tissue out of her sleeve cuff and blew her nose. "I'm sorry. I'm sorry, I don't mean to break down. It's just the worst I've ever seen her."
Véronique patted her shoulder just before she released the brake on the stretcher.
Mrs. Schuster wiped her eyes. "Thank you, you've all been so..." She saw me and her eyes widened and her shoulders jerked. "Oh, my God." She put her hand to her chest.
"I know, Mom," said Wendy.
Mrs. Schuster gaped at me, still blocking the stretcher.
Was this because she'd seen the 'detective doctor' articles? What was the big deal, anyway?
"Mom?" called the RT.
Wendy steered her mother out of the way. "It's okay, Mom. That's just a resident. Her name's Dr. Zee or something."
Véronique said, "ICU's on the second floor. Can you follow us in the next elevator? It's going to be cramped."
"Sure," said Wendy, since Mrs. Schuster was rubbing her forehead like she had a headache.
I wanted to follow them up, but I had to give them some space. I'd check on her later. In the meantime, Brigitte was signaling me back to the psych corner. It was going to be a long night.